Our community must not miss this opportunity

Our community must not miss this opportunity

11 January 2017

THE public meeting organised by the Department of Health taking place in Downpatrick Cricket Club tomorrow night at 7pm may well present the best opportunity for a generation to secure and enhance service provision in the Downe Hospital. 

At that meeting, the proposed criteria for reconfiguring health and social care services will be discussed. The criteria ultimately used will be key determining features in the future role of the Downe Hospital — the people’s hospital. 

Built as a result of unrelenting public pressure over a period of 40 years, the people’s hospital is indeed a fine hospital, providing many excellent services to our local community.

Despite the clinical assessment that determined that our community needs a 24-hour emergency department, we have been deprived of a full service as resources are deployed elsewhere. Our designated coronary care unit was also stripped from the Downe to save money during a financial crisis in Stormont.

And the issues are not unique to the Downe or Down District. Other communities suffer too and surely it is unconscionable that Newry’s Daisy Hill Hospital should lose its stroke unit.

Severe cuts have hit the Lagan Valley and Causeway hospitals and other facilities that have a proud tradition of meeting the needs of local communities. The centralists have had their say for 40 years. They have had their way, but have the outcomes been good?

Bed numbers have been cut and surely the politicians who should run the health service can see a correlation between a 16% cut in acute bed numbers in Northern Ireland between 2009 and 2014 and the trolley waits and bed blocking that are by-symptoms of a healthcare system that is under resourced and where, some would argue, resources have been misallocated?

The historic lack of political will to ensure an end to the discrimination against citizens who live outside the Greater Belfast area must now be addressed. It has been the proverbial elephant in the room.

Belfast hosts only 21.8% of the population of Northern Ireland so how can the presence of the three Type 1 emergency departments at the Royal, Mater and Ulster hospitals be justified? And, of course, the Lagan Valley Type 2 unit is just a few moments away along a fast motorway. To perpetuate this injustice, where limited resources are misallocated can no longer be tolerated.

Staffing issues are, of course, a major problem for the health service. They would be understandable as a limiting factor in terms of service location and distribution were it not for the fact they have been well known and documented for years. Why are we short of GPs, why are we short of consultants in some specialisms? 

There has been a monumental failure, in the opinion many of observers, in workforce planning across the health service in the United Kingdom and Ireland. Staffing issues are a short and medium term problem; they can be addressed in the medium term. To allow them to stampede us into long term decisions about service reconfiguration would be a nonsense.

The centralists have had their way for years. Where do we find ourselves now? It is but common sense, when one finds oneself in the proverbial hole, to stop digging. I hope that Health Minister Michelle O’Neill will take away their shovels.

So faced with ongoing crises, change is necessary.  But the changes that are needed will take some time to implement.  And they must deliver a better service for the patients who pay for it.

The Bengoa Report, launched by the Health Minister last October, contains general principles with which few would disagree. The ministerial programme launched on the same day entitled Health and Wellbeing 2026 Delivering Together contains some very welcome commitments and proposals.

Ms O’Neill has now submitted to public consultation, the criteria that her Department wishes to apply in the reconfiguration of services. Tomorrow night’s meeting is part of that programme of consultation and it is essential that our entire community turns out to the Cricket Club to demonstrate support for the Downe Hospital and the National Health Service.

There are some disturbing features in what is proposed. Firstly, an opportunity to address inequality may be missed, while secondly, the entire strategy ignores the substantial change of direction in hospital provision now being implemented in England.

Small and medium-sized hospitals are now recognised as being crucial in meeting the healthcare needs of the citizens, and the historic policy of centralisation is being reviewed. NHS chief executive, Simon Stevens, signalled the change in 2014 as soon as he was appointed because it was recognised that centralisation had gone too far.

And ongoing work by, for example, the Nuffield Trust-sponsored New Cavendish Group has provided much food for thought. Why have such important changes not been at the heart of strategy or at least debate in the North of Ireland?

A shortly to be published report by Plymouth University on dementia sufferers in rural areas recognises the particular needs of that group and their families. This is another example of the difference between the needs of the privileged Belfast City dwellers and the rest of us. 

As part of the Health and Wellbeing 2026 document launched by Ms O’Neill, a consultation has been launched on “criteria for reconfiguring health and social care services.” Our community must not miss this opportunity to have its say.

It is imperative the community turns out tomorrow night at Downpatrick Cricket Club, despite the potentially inclement weather, to listen to the Department of Health and its consultation team.

Then, as many individuals, elected representatives, community, sporting and cultural organisations need to respond before the looming January 20 deadline when consultation closes.

People can also respond by letter to the Department of Health’s consultation questionnaire and responses can be emailed to Reconfig.criteria@health-ni.gov.uk or by post to the Reconfiguration Criteria Consultation, Department of Health, Room C3-6, Castle Buildings, Stormont Estates, Belfast, BT4 3SQ.